Catholic Charities arm serves HIV/AIDS clients and families

A politician recently remarked in a National Public Radio interview, "Abortion is a tired issue right now." Joseph Kerwin believes that, unfortunately, the public feels the same way about HIV/AIDS.

"Bioterrorism, Michael J. Fox with Parkinson's disease, stem-cell research -- those are the issues of the day. AIDS is not attractive any more," stated Mr. Kerwin, director of Catholic Charities AIDS Services for the Albany Diocese.

The approximately 125 people his agency serves in ten counties of the Albany Diocese might disagree. They represent just a small fraction of those living with HIV/AIDS in New York State; the last available statistics for those counties (from 2001) listed nearly 1,600 people with the virus.

Since the World Health Organization estimates that 30 percent of all HIV/AIDS cases are underreported, Mr. Kerwin pointed out, the statistics are woefully short of the real number.

Linking services

Clients are referred to Catholic Charities AIDS Services mostly by Albany Medical Center, the main HIV/AIDS treatment center for this area, but also by primary care doctors and substance abuse treatment providers. The agency works not just with clients infected with HIV/AIDS, but also with their spouses, roommates, partners and children.

"Our goal is to get our clients [and their loved ones] into a position where they can maintain the best quality of health possible. They can get their meds, get rest, do all the things they need to do to manage their illness," Mr. Kerwin told The Evangelist.

Often, that means first matching a client with a primary-care physician. The agency's case managers -- each of whom carries a load of up to 25 cases -- will bring clients to doctor's appointments, make sure they're taking their medications correctly, arrange long-term care for their children and even, in the end, make funeral arrangements.

"A case manager is a link to all other services," said Mr. Kerwin. Living with HIV or AIDS "can be a very isolated existence; our case manager can be [the client's] family, friend, service provider. [The client's] whole regime can revolve around what time they have to take meds, whether they're tired or nauseous, whether they're able to eat."

Many problems

That's especially true with the many clients for whom AIDS is simply the latest diagnosis in a litany of health and social problems.

The director asserted that the general public doesn't understand how closely HIV is tied to poverty, unemployment, mental illness and substance abuse. Part of a case manager's job, he said, may be to help a client maintain sobriety from an addiction, or connect him or her with mental health services.

"The folks we're serving often are poor, disabled or those with other issues that make it difficult for them to function in society," Mr. Kerwin noted. "HIV and AIDS becomes just another thing for them to deal with."

Out there

HIV infection may also be viewed as an "urban issue," but Mr. Kerwin has seen more and more cases cropping up in rural areas. Two years ago, for example, Greene County had the highest increase in HIV infection in all of New York State. Isolation, explained Mr. Kerwin, leads to substance abuse, which, in turn, can lead people to engage in risky behaviors.

Worse yet, those in rural areas where "everybody's business is my business," he said, may not seek diagnosis or treatment because they're afraid their neighbors will find out. Those who do learn they're infected may sink into depression and stop taking necessary medications.

"Our case managers are constantly monitoring that," he noted. A client in crisis, he said, may be visited by a case manager two or three times in one week.

Transportation is a major issue for clients in outlying areas. Since Albany is the hub for care, case managers may have to bring clients from as far away as Hudson or Delhi to see doctors in Albany.

New problems

Mr. Kerwin said his work has eased during his four years as director in that clients are living longer and their quality of life has improved, but that in itself has led to other issues.

For example, he said, AIDS patients are dying of heart disease and liver failure brought on by taking the toxic drugs used to treat AIDS on a long-term basis. In addition, the public misconception that the "cocktail" of drugs used to hold the infection at bay is a cure means people aren't as concerned about getting AIDS as they were when infected patients died quickly.

Fewer "people are being tested up front than in the past, so a lot of the referrals we're getting have been HIV-positive for a long time but were unaware, so they're already sick -- and not everybody responds to the drugs," he added.

Funding

Because AIDS isn't in the public eye as often as it once was, funding has dropped. Mr. Kerwin said that in his field, "everybody's waiting" to see whether the Ryan White Care Act (a major source of federal funding for AIDS services) will be reauthorized and whether Medicaid block grants will be enacted.

Also at stake are federal funds that New York State has received for years but that are now threatened because southern states are seeing more of an increase in HIV infection rates. The result is that the monies may be sent there instead.

Mr. Kerwin said research into developing an AIDS vaccine has also collapsed. "You can't cut the services if the number of people needing the services keeps increasing," he stated.

Prevention

Working for a Catholic agency trying to prevent HIV infection also presents problems.

"Our prevention messages don't seem to be working," he admitted. "Young people are continuing to show higher rates of infection; communities of color and the gay community are showing a new rise in infection."

The statistics he cited are chilling: Although people of color represent only 17 percent of the population of New York State, they account for 80 percent of the HIV infections. Because of the social stigma of having HIV/AIDS, he added, many people know they've engaged in behaviors that put them at risk for getting the disease, but simply don't want to know if they've been infected.

Apathy

While he cautioned that it's too soon to predict whether the increase will continue, he called the trend "frightening. We've lulled society into apathy; people are tired of hearing about it."

AIDS Services is pushing for more people to be tested for HIV -- and tested early, when there are more options for treatment.

"If people have any inkling that they could have put themselves at risk, they should be tested," Mr. Kerwin urged. "It's always better to know.

"When we talk about fighting poverty and fighting for social justice, we're talking about helping people protect themselves from things like HIV and AIDS. The social justice mission of our Diocese is among the things we [at Catholic Charities AIDS Services] do really well. To address people who are in need, suffering, marginalized, poor is the heart of what it means to be a Christian for me. Catholic Charities embodies viewing people with a sense of self-worth and dignity; that's what keeps me here. We can bring a message of hope because we're grounded in the mission of the Diocese."

TEN COUNTIES

Diocesan services re: HIV/AIDS

In the 1980s, Bishop Howard J. Hubbard formed a diocesan task force to "respond to the reality of AIDS." Among the members was Sister Maureen Joyce, RSM, executive director of diocesan Catholic Charities. From that task force sprung efforts at diocesan AIDS ministry, ranging from retreats to the opening of the Farano Center in Albany, which cares for infants with HIV/AIDS.

Eventually, all diocesan AIDS services were placed under the umbrella of Catholic Charities; in 1994, the Catholic Charities AIDS Services agency was formed. Today, Catholic Charities AIDS Services has five offices (and an administrative office) serving ten counties of the Albany Diocese: Albany/Rensselaer, Schenectady, Fulton/Montgomery, Columbia/Greene and Delaware/Otsego/Schoharie.

AIDS Services also oversees the Catholic Charities Transportation program, an all-volunteer effort to shuttle people in need to doctor's appointments and hospitals. (KB)

How to help

* Hold a parish or school fundraiser to benefit Catholic Charities AIDS Services; call 449-3581.

* Walk in the annual AIDSWalk (Sept. 26 at Washington Park in Albany) to raise money for Catholic Charities AIDS Services. Call AIDS Services at 449-3581 or the AIDSWalk information line at 448-WALK, or visit www.aidswalk-capitalregion.org.

* Volunteer as a driver for the Catholic Charities Transportation program; call 271-1418.

Parishes that regularly hold fundraisers for Catholic Charities AIDS Services include St. James, Cathedral and St. Vincent's in Albany; Annunciation in Ilion; and St. Mary/St. Paul's in Hudson Falls.

Schools include Bishop Maginn High and the Academy of the Holy Names in Albany, and Catholic Central High in Troy. Holy Names students serve a monthly lunch for clients at the Damien Center in Schenectady, which serves people with HIV/AIDS. (KB)

(7/29/04)